Individual provider Active NPI

Ruben Carabali

  • Physical Therapy Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1609744754
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA24827 Issued in FL
Practice address
240 NW Peacock Blvd Ste 104
Port Saint Lucie, FL 34986-2274
Phone
(561) 344-8254
Fax
(772) 673-5807
NPI assigned
Oct 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA24827 FL Primary

Addresses

Primary practice location

240 NW Peacock Blvd Ste 104
Port Saint Lucie, FL 34986-2274

Mailing address

2627 Fillmore St
Hollywood, FL 33020-4327
Phone (954) 822-8560

Other practice location 1

1809 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5544
Phone (561) 344-8254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111002284 FL Practitioner - Physical Therapist in Private Practice 2860983525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1809 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5544

2627 Fillmore St
Hollywood, FL 33020-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTA24827FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
One Faith Therapy Inc. CurrentSince Oct 29, 2025 Accepting new patients

Locations

240 NW Peacock Blvd
Ste 104
Port Saint Lucie, FL 34986
Phone (561) 344-8254

1809 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (561) 344-8254

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1609744754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 FILLMORE ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204327",
            "telephone_number": "954-822-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 NW PEACOCK BLVD STE 104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862274",
            "telephone_number": "561-344-8254",
            "fax_number": "772-673-5807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1809 SE Port St Lucie Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349525544",
            "country_code": "US",
            "telephone_number": "561-344-8254",
            "fax_number": "772-673-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARABALI",
        "first_name": "RUBEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA24827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.